HomeMy WebLinkAboutPermit Building 1992-12-21
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOT:
SPRINGFIELD
BLOCK:
JOB NUMBER
q8 '2'34
225 Fifth Street
SUBDIVISION:
OWNER: (_.bf()r\rt+~ \_~\1n-h. f1-. . -. PHONE: ~3++C)()~R
ADDRES~f] ( 0 '7-.!J 0.J I II (J ](()J/LL AJ ~ f:!!J(\ Z-
CITY '(J)(lfJ1-2 ~ ~ STATE, u).LQ~~ ZiP, Cf1-1O/
DESCRIBE WORK~ llfJO A A I l J,.)1J) 0 ( Uj \. ~ t\ ') Ut00
NEW REMODEL.J ADDITION ~~L1SH OT-HER
CONST.
ADR~ESS n1LfjCONTRACTOR 1/ EXPIRES PHONE
~~dJ~. \C' r / 1~() q/Cl~\34{J-~
L l
CONTRACTOf'S NAME
GENERAL:\..J1,D.f ~ 11 \'\}_~ 0
PLUMBING:
MECHANICAL:
ELECTRICAL:
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
1/ OF BLDGS: 1/ OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR, TYPE: 1/ OF BDRMS:
1/ OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE' SQUARE FOOTAGE:
To request an inspection, you must call 726.3769, This Is a 24 hour recording, All inspections requested before 7:00 a.m, will be
made the same working day. Inspections requested after 7:00 a,m. will be made the following work day. '
REQUIRED INSPECTIONS
D Te.mporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover,
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/ Mechanical
- Prior to Insulation or decking,
D
Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench, .
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover,
D Rough Electrical - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp,
~,"ming - P,'o, to oo'e'.
~all/ceiling InSUlati.on - Prior to
cover,
rf'Ywa" - P,io, to taping.
o Wood Stove - After Installation.
o
Insert - After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Drivewa:l - After
excavation is complete, forms
and sub-base material in place.
D Fence - When completed.
D Street Trees - When all required
trees are planted,
D
Final Plumbing -- When all
plumbing W9rk Is complete,
D Final Electrical -'- When all
electrical work is complete,
D Final Mechanical - When all
mechanical work is complete, .
f4
inal Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Electrical Connection - When
blocking. set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting. decks. and
venting have been installed.
Lot faces
...."; "1', ~
t..
\.~. Lot Tn>e
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac.
BUILDING PERMIT
ITEM
SO, FT.
X $/SO, FT.
Main
Garage
Carport
Total Value
Building Permit 'Fee
State Surcharge
Total Fee
(A)
.: ~ t. _. fi"~G,~'~~1~'~~_~~(~~~~~~-~"~~z:". .Jl.~';,~,.~
r' ~""''1''~~~ ;.,~-;.\~ . ' ..\..,,.,:\~&,, ~.'?; 'J"', h:1l1',-. .l':, l~t.~ltl,.'\~r ;h'J
~ oi~t::i~.~~ \.~ .:<":.";, ?5~" _~i!;}:'~:'\'.'~-'~;~}~,~~~~~,~,~, ;;;.. ..
Setbacks
'\ .',-,;",'
.3 THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, ()R ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the, Historical
, Coordinator prior to permit issuance.
I P,L. ' HSE GAR ACC
IN
S
W
E
VALUE
. '
-50r). 00
ICO. ()()
· r;:s
J5.L5..
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined) , '
FEE
18.!b
I
I
I
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the exp'ress condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildirigs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee:
Date Paid:
Re<:;ei pt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
B'y signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further certify
that any ana all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregori pertaining to the work described
, herein, and that NO OCCUPANCY will be made of any
struc'ture'without p'crmissio'n of the BLJilding Safety Division,
I furthEH certi fy that only contractors and employees who
are in compliance with bRS 701.055 will be used on this
project.
- ,)u/ry--
, I I
'. ,
VALIDATION: ~(jr.v-
RECEIPT NU~~ER _ /_ DD CJ .
bATE PAID W c9 j. q _"
AM6UNTR~~~V I~.r~
RECEIVED Y . (lY).. ~ '
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